NHS Could Save Millions If People With MRSA Were Treated At Home, Report

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Main Category: MRSA / Drug Resistance
Also Included In: Infectious Diseases / Bacteria / Viruses;  Public Health
Article Date: 07 Jan 2008 - 3:00 PDT

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A new UK expert report that attempts to separate MRSA facts from fiction makes a number of recommendations and suggests the NHS could save millions if people with MRSA were sent home and not kept in hospital.

Home based treatment could also be better for the patient, said the report which was sponsored by the drug company Pfizer and produced by a panel of experts called the MRSA Separating Fact from Fiction Working Group in collaboration with the campaign group National Concern for Healthcare Infections.

The report said there is a need for an "integrated approach to the management, treatment and prevention of MRSA infection".

Key to achieving this are clean hospitals, good infection control, and better information and treatment for patients.

Patients with MRSA tend to stay in hospital 11 days longer on average than uninfected patients. This is typical of healthcare-associated infections (HAI), of which MRSA is but one. Others include Clostridium difficile and a range of infections that can be caught from other patients.

About 1 billion pounds a year is spent treating HAIs in the UK, said the report, most of it on treating people who are kept in hospital longer. Most people with MRSA are treated in hospital, and the expert panel suggests if there is no medical reason for staying in hospital, the infection should be treated at home.

One of the panel, Professor of Medical Microbiology, University of Leeds, and Head of Microbiology, Clinical Director of Pathology and Infection Control Doctor, The Leeds Teaching Hospitals, Dr Mark Wilcox said:

"Treating people with MRSA at home offers multiple benefits in terms of infection control, and reducing NHS costs and resource use."

"Many patients would also prefer to be discharged from hospital to be with their families while they finish their treatment, and they should be given that option, where possible," he added.

Home treatment could either be supported by nurses giving patients antibiotic injections or with oral antibiotics that work against MRSA.

One of the myths surrounding MRSA, that many people believe, is you can catch it easily from someone who has it. That is not the case, as MRSA generally infects through open wounds or IV lines, said the report's authors.

NCHI representative, Neil Manser said it was important to give the public clear and accurate information about MRSA, and this report was doing just that:

"Misconceptions around MRSA risk affecting public confidence in hospital treatment," said Manser, and "out of sheer ignorance, many people who have been infected by MRSA have unjustly been made to feel ostracised," he added.

The report calls for the following action:

• Give people accurate and user friendly information about MRSA and other HAIs.


• Tell people with MRSA about treatment options, including home treatment, if appropriate.


• Involve MRSA patients in treatment decisions.


• Consult the specialists, for instance microbiologists, about how to manage patients with MRSA and other HAIs.


• Hospital trusts should be ready to help MRSA patients be treated at home, if appropriate.


• MRSA patients treated at home should be supported and followed up and be given ongoing access to information and advice.

MRSA is one of the most common healthcare-associated infections (HAIs) in the UK. It stands for methicillin-resistant Staphylococcus aureus (S. aureus or "staph"). It is resistant to methicillin and other antibiotics like penicillin and amoxicillin, otherwise it is no different to other staph bacteria.

About 1 in 3 of the general population carry staph bacteria around all the time, on their skin, inside their nose, but they are not "infected" with it and suffer no ill effects. About 3 per cent of the population carry the resistant form of staph, or MRSA.

If MRSA gets into the bloodstream then the person becomes infected with it. Entry occurs through open wounds, medical instruments or devices used to inject drugs (such as intravenous lines) or via breathing tubes into the lungs.

This can result in skin infections, lung infection (pneumonia) and bloodstream infection (bacteraemia).

MRSA infection can be very serious, resulting in hospitalization and sometimes death.

"MRSA: Separating Fact from Fiction."
Written by: MRSA: Separating Fact from Fiction Working Group.
Issued: January 2008.

Click here for the full report (PDF).

Written by: Catharine Paddock
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today